Nursing Care of Colon Elimination

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Questions and Answers

What is the primary purpose of combining medication with oil or saline in a therapeutic enema?

  • To enhance the flavor of the medication
  • To facilitate the rapid absorption of the medication
  • To decrease the likelihood of irritation and expulsion (correct)
  • To increase the volume of the enema solution

How much solution typically makes up a medical enema for adults?

  • 30 - 60 ml
  • 150 - 250 ml
  • 60 - 180 ml (correct)
  • 250 - 500 ml

What is the main function of an evacuant enema?

  • To introduce a contrast medium for diagnostics
  • To hydrate the bowel for regular function
  • To promote bowel movement and relieve constipation (correct)
  • To administer medication for systemic absorption

What is included in the diagnostic enema procedure?

<p>Injecting a contrast medium into the large intestine (D)</p> Signup and view all the answers

What type of syringe is typically used for administering an evacuant enema?

<p>A Janette rectal syringe with a rectal tube (A)</p> Signup and view all the answers

What does the presence of bright red blood in the stool indicate?

<p>Rectal or lower colon bleeding (B)</p> Signup and view all the answers

Which stool shape may suggest narrowing of the rectum or anal opening?

<p>Pencil-like (C)</p> Signup and view all the answers

What characteristic odour might suggest the presence of digested blood in stool?

<p>Sweet smell (C)</p> Signup and view all the answers

What does floating stool typically indicate?

<p>Undigested fats (A)</p> Signup and view all the answers

Which of the following is a common sign of constipation?

<p>Bowel movements less than every 3 days (C)</p> Signup and view all the answers

What does the presence of pus or mucus in stool indicate?

<p>Inflammation or infection in the digestive system (D)</p> Signup and view all the answers

What is the medical term for the presence of black stool?

<p>Melena (D)</p> Signup and view all the answers

Which of the following could suggest a malfunction in the digestive system?

<p>Presence of tapeworms (C)</p> Signup and view all the answers

What is stool impaction primarily caused by?

<p>Unrelieved constipation (A)</p> Signup and view all the answers

Which patient population is most at risk for stool impaction?

<p>Elderly and immobile patients (C)</p> Signup and view all the answers

What characterizes diarrhea?

<p>Increase in the number of liquid stools (B)</p> Signup and view all the answers

What is the suitable size of a rectal tube for a school age child?

<p>16-18 (A)</p> Signup and view all the answers

What is stool incontinence?

<p>Inability to control stool and gas elimination (C)</p> Signup and view all the answers

Which type of enema is specifically administered for removing constipation?

<p>Cleansing enema (A)</p> Signup and view all the answers

What does a Stool Management System (SMS) primarily aim to do?

<p>Prevent and contain stool leakage (B)</p> Signup and view all the answers

What volume of solution is recommended for a high cleansing enema administered to adults?

<p>1000-1500 ml (A)</p> Signup and view all the answers

Meteorism is primarily associated with the accumulation of what in the intestines?

<p>Gas in the intestinal lumen (B)</p> Signup and view all the answers

What should be assessed before administering a cleansing enema?

<p>Patients history of allergy to enema solutions (B)</p> Signup and view all the answers

Which of the following factors may lead to reduced intestinal motility, contributing to meteorism?

<p>Opiates and general anesthetics (D)</p> Signup and view all the answers

What is the primary purpose of a low cleansing enema?

<p>Cleanse the rectum and lower part of the large intestine (B)</p> Signup and view all the answers

What is a common consequence of stool impaction if not resolved?

<p>Intestinal obstruction (D)</p> Signup and view all the answers

Which additive is sometimes included in a warming liquid for adults receiving a cleansing enema?

<p>Castor oil (D)</p> Signup and view all the answers

What is the main function of a diagnostic enema?

<p>To aid in the examination of the intestines (B)</p> Signup and view all the answers

What should be verified before administering a cleansing enema?

<p>The patient’s allergies to enema ingredients (A)</p> Signup and view all the answers

Why is regular elimination of colon waste products essential for normal body functioning?

<p>It maintains homeostasis. (D)</p> Signup and view all the answers

Which factor is NOT typically associated with influencing bowel elimination patterns?

<p>Amount of sleep (C)</p> Signup and view all the answers

What characterizes stool frequency and characteristics in breastfed infants?

<p>Loose, seedy, golden yellow stools, often after every feeding. (B)</p> Signup and view all the answers

At what age do toddlers typically become physically ready to control bowel elimination?

<p>18 to 24 months (B)</p> Signup and view all the answers

What role does nurse assessment play in patient care concerning colon elimination?

<p>It assists in identifying abnormalities in stool characteristics. (B)</p> Signup and view all the answers

Which statement about changes in colon elimination is correct?

<p>Changes in elimination may indicate an illness or may cause illness. (B)</p> Signup and view all the answers

What is a fundamental nursing responsibility regarding patient elimination?

<p>Observing colon function and assessing stool. (A)</p> Signup and view all the answers

Which of the following best describes the relationship between colon elimination and homeostasis?

<p>Effective colon elimination contributes to maintaining homeostasis by removing waste. (D)</p> Signup and view all the answers

What is the first step to take when a patient lacks knowledge about the cleansing enema procedure?

<p>Begin education about the cleansing enema (B)</p> Signup and view all the answers

Which position is typically recommended for the patient during the cleansing enema?

<p>Sim's left position with upper leg flexed (B)</p> Signup and view all the answers

Which of the following is NOT a safety measure to prevent cross-contamination during the procedure?

<p>Preparing equipment in a non-designated area (D)</p> Signup and view all the answers

What should be explained to the patient during the cleansing enema procedure?

<p>They should keep the enema liquid for a duration of 15-20 minutes (D)</p> Signup and view all the answers

What is a critical component to assess before performing the cleansing enema?

<p>Condition of the patient's rectal area (A)</p> Signup and view all the answers

Which item is NOT essential for the equipment setup for a cleansing enema?

<p>Patient's personal belongings (D)</p> Signup and view all the answers

What is the purpose of talking to the patient throughout the cleansing enema procedure?

<p>To explain each step and minimize their anxiety (A)</p> Signup and view all the answers

Which of the following actions should be taken after identifying the patient?

<p>Adjust the bed to a comfortable working height (A)</p> Signup and view all the answers

Flashcards

Enterorrhagia

The stool is bright red, indicating bleeding from the rectum or lower colon, often caused by hemorrhoids or cancer.

Yellow or Greenish Stool

The stool is yellow or greenish, suggesting the presence of microorganisms and an infection.

Nut-like Stools

Separate hard lumps like nuts indicate dehydration.

Pencil-like Stool

Long, thin, pencil-like stools suggest a narrowing of the rectum or anal opening, potentially caused by a tumor.

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Constipation

A decrease in the frequency of bowel movements accompanied by the passage of hard, dry stool.

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Tenesmus

A feeling of incomplete evacuation, often accompanied by straining and rectal discomfort.

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Pus or Mucus in Stool

The presence of pus or mucus in stool indicates inflammation or infection in the digestive system.

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Undigested Food in Stool

The presence of undigested food products in stool suggests digestive system malfunction.

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Colon Elimination

Elimination of waste products from the body, essential for maintaining homeostasis.

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Normal Elimination

The normal process of eliminating waste from the body is usually smooth and uneventful, unless a change in habits or illness occurs.

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Changes in Bowel Habits

Changes in bowel habits can signal health problems or even cause them.

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Assessment of Colon Function

The assessment of stool consistency and how well the colon is functioning is a fundamental part of nursing practice.

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Variations in Stool Characteristics

Stool characteristics vary across individuals and change throughout life due to age, diet, lifestyle, and overall health.

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Infant Stool

Infants lack the neuromuscular control to regulate defecation, leading to frequent and often loose bowel movements.

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Toddler Bowel Control

Toilet training and cognitive development play a crucial role in achieving bowel control between 18 and 24 months of age.

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Factors Influencing Colon Elimination

A variety of factors like age, diet, lifestyle, and stress can influence bowel function. Understanding these factors is key to managing elimination issues.

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Cleansing Enema

A type of enema used to clean the intestines, commonly used for constipation, pre-operative prep, examinations, and childbirth preparation.

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Low Cleansing Enema

A type of cleansing enema that cleanses the rectum and the lower part of the large intestine.

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High Cleansing Enema

A type of cleansing enema that cleanses the upper sections of the large intestine.

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Yal Solution

A commercially prepared enema solution commonly used as a low cleansing enema.

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Diagnostic Enema

A type of enema used for diagnostic purposes.

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Microenema

A type of enema used for medical purposes including treating constipation.

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Cleansing Enema Administration

The procedure of administering a cleansing enema involves first assessing the patient, then administering the enema based on the patient's specific needs.

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Delegation of Cleansing Enema Administration

The administration of a cleansing enema can be delegated to nursing assistive personnel.

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Evacuant enema

An enema that removes waste from the lower intestine, used to relieve constipation.

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Medical enema

A type of enema that delivers medication directly into the rectum for faster absorption into the bloodstream.

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Barium sulphate

A chalky white liquid used in diagnostic enemas to coat the colon and make it visible on an X-ray.

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Cleansing Enema Procedure

The process of administering a cleansing enema to a patient.

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Patient Education

Ensuring the patient understands the purpose and steps of the cleansing enema.

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Patient Preparation

Preparing the patient mentally and physically for the cleansing enema procedure.

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Sim's Position

The position where the patient lies on their left side with their upper leg flexed, commonly used for cleansing enemas.

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Supine Position

The position where the patient lies on their back with their legs flexed, sometimes used for cleansing enemas.

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Rectal Tube

A device used to administer the cleansing enema solution into the rectum.

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Enema Solution

A solution, usually warm water, used to cleanse the colon during a cleansing enema.

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Implementation of Cleansing Enema

The set of steps involved in setting up the enema equipment, preparing the patient, and administering the enema solution.

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Stool Impaction

The buildup of hardened stool within the lower colon, often forming a large, difficult-to-pass mass. It frequently occurs in those who experience chronic constipation.

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Stool Incontinence

The uncontrollable passage of stool or gas from the anus. This can be caused by various issues, such as impairments to the nervous or muscular systems.

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Stool Management System (SMS)

A system designed to manage stool incontinence, preventing leakage, managing odors, and protecting the skin around the anus. Includes devices like stool collectors, bags, and pouches.

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Diarrhea

An increase in the number and liquidity of bowel movements. It's often related to issues with digestion, absorption, or secretion within the digestive tract.

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Meteorism

The buildup of gas within the intestines, causing bloating, discomfort, and potential pain. This often occurs due to reduced intestinal motility, swallowing air, or digestive issues.

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Rectal Enema

A medication administered through the rectum (anus) to treat various conditions, including constipation, diarrhea, and inflammation in the lower digestive tract.

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Study Notes

Care of Colon Elimination

  • The body eliminates waste products to maintain homeostasis. Normal elimination is routine and uneventful, but changes in habits or illness can affect it.

  • Changes in bowel habits might indicate illness or cause illness.

  • Assessing bowel function, including stool observation and collection, is a fundamental nursing responsibility.

  • Understanding stool characteristics and normal elimination patterns aid in identifying abnormalities.

  • Regular bowel elimination is essential for body functioning.

  • Changes in bowel elimination can be early symptoms of GI or other body system problems.

  • Elimination habits vary among individuals. An understanding of the factors that influence, cause, and impede elimination is helpful for management.

  • Patient privacy and emotional needs should be respected in nursing care for elimination problems.

  • Strategies to promote normal elimination should minimize patient discomfort.

Factors Influencing Colon Elimination

  • Age significantly affects elimination patterns, changing throughout the life cycle.
  • Diet (fibre intake), lifestyle, personal habits, health status, and emotional state also influence bowel elimination.

Infant and Toddler Elimination

  • Infants lack the neuromuscular maturity to control defecation.
  • Stool frequency and characteristics depend on infant feeding method.
  • Toddlers typically gain control between 18-24 months.

Older Adult Elimination

  • Older adults (over 65) often experience constipation due to muscle tone loss.
  • Elderly individuals may have more difficulty controlling defecation.
  • Diet plays a role in maintaining regular elimination, with high-fibre foods promoting healthy elimination.

Hydration and Elimination

  • Adequate fluid intake is crucial for healthy bowel movements (1500-2000ml per day suggested for adults).
  • Fluid is essential for nutrient and electrolyte absorption.

Pain and Medications

  • Pain can negatively affect bowel function, leading to discomfort and constipation.
  • Certain medications can alter bowel function or cause constipation or diarrhea.

Diagnostics

  • Diagnostic procedures may temporarily alter peristalsis.

Psychological Factors

  • Psychological factors such as stress and depression can lead to bowel elimination problems.
  • Stress and depression can lead to reduced peristalsis and constipation.

Stool Assessment

  • Stool consistency, amount, colour, shape, odour, and presence of abnormal components are key assessment elements.
  • Nurses observing stool's characteristics including consistency, frequency, regularity, and presence of abnormal elements.

Enema Administration

  • Cleansing enemas cleanse the intestines for preoperative procedures, exams, or constipation.
  • A high enema is used to cleanse the upper intestine, while a low enema cleans the rectum and lower colon.
  • The volume of cleansing solution varies by age.
  • Enmas are used for various reasons such as therapeutic, evacuant, or diagnostic.

Stool Measurement

  • Daily dietary intake and the physical amount and quantity of stool greatly affects its consistency and shape.
  • Other indicators of stool are its odour, colour, and density.

Colon Elimination Disorders

  • Constipation: infrequent bowel movements, difficulty passing stools.
  • Diarrhea: increased frequency of diarrhea stool, watery or loose stool.
  • Impaction: severe constipation, accumulation of hard stools in the rectum.
  • Stool incontinence: uncontrollable loss of stool.

Stool Management Systems (SMS)

  • Effective in managing stool incontinence at home, in hospice or hospital.
  • These devices contain stool leakage.
  • Includes devices to prevent and contain stool

Diagnostic Enemas

  • Used to administer contrast medium, e.g., barium, to visualize the colon via X-ray to diagnose issues.

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